Fetal surgeries are conducted to solve health problems of the fetus. The reason for this is that in some cases, the absence of any intervention can lead to the deterioration of the fetus health.
Blood transfusion to the fetus in the womb
This procedure is performed in situations of blood incompatibility or fetal anemia and consists of blood transfusion to the fetus accompanied by ultrasound through the umbilical cord. The results of this simple operation are very successful, and the risks are relatively low. It often saves the life of the fetus.
Treatment of myelomeningocele
This is a neural tube defect, colloquially known as a hole in the back, accompanied by a buildup of fluid in the fetal head. Intrauterine surgery, in this case, is proven to be superior to postpartum surgery.
Congenital cystic adenomatoid malformation
This lung lesion, on the one hand, presents a problem for the development of the fetal lungs, on the other hand, it puts pressure on the chest, which makes it difficult for blood to move from the vessels to the heart. As a result of problems with the cardiovascular system of the fetus, it may have problems with the lungs after birth.
The diaphragm is a hard membrane that separates the thoracic and abdominal cavities. Ruptures in this membrane lead to the fact that the intra-abdominal organs (stomach, liver) fall into the chest cavity, and prevent the development of the lungs, exerting pressure on them. Promising studies are showing that by placing a balloon device in the trachea of the fetus, it is possible to reduce lung development problems.
Congenital heart disease
Strictures (aortic or pulmonary stenosis) that occur during the outflow of blood from the heart can harm the cardiovascular system, which leads to the need for postpartum surgery. Recently, studies have been conducted and published showing that balloon dilation of these strictures, accompanied by ultrasound, can be very useful.
Obstruction of the lower urinary tract
Lesions that prevent the exit of fetal urine (most often the posterior urethral valve) first cause stagnation of urine in the fetal bladder, and with progression – in the urethra and kidneys, which leads to kidney failure. Besides, the lack of amniotic fluid negatively affects the development of fetal lungs. Providing full-fledged urination of the fetus in the womb increases the chances of survival of newborns. This happens either by bypass surgery or by laser removal.
Professor Dr. Selahattin Kumru, vesicoamniotic catheter insertion surgery.
Professor Dr. Selahattin Kumru, vesicoamniotic catheter insertion control surgery.
Twin-to-twin transfusion syndrome
Twin-to-twin transfusion syndrome is a serious complication that occurs during the pregnancy of twins with one placenta (monochorionic pregnancy). In cases where connective vessels are formed between the veins coming from one placenta, the blood pumped by the heart of one fetus (donor) can flow in excess to the second fetus (recipient). The continuous flow of blood pumped from one fetus to other causes anemia (anemia), developmental delay, and the amniotic fluid deficiency (oligohydramnios) in the donor fetus, while the fetus receiving the blood (recipient) also has an increase in blood volume (hypervolemia), an excess of amniotic fluid (polyhydramnios), and weight gain. If you do not interfere with this process, the fetus that loses blood will not survive due to anemia, and the fetus that receives blood in excess will also not be able to survive due to heart failure caused by excessive exercise due to a large volume of blood. The death of one of the infants exacerbates the problem and can lead to death or severe disability of the other.